I propose to establish and explain racial differences in Active Life Expectancy (ALE). Racial disparities in health and mortality have long been of interest to demographers and social scientists more generally, and it is well known that nonwhites have poorer health and higher mortality rates than whites. ALE is a measure that combines both health and mortality information into a concise summary of remaining life that one can expect to live free from disability. Recent research has investigated racial differences in ALE but has been severely limited in several ways. First, studies have not examined life course patterns in ALE; instead, research has focused on inequalities at one particular age (e.g., at 65). Yet there are theoretical reasons to expect ALE differences to change across age (e.g., heterogeneity and selection). Second, studies of racial inequality in ALE have not been statistical. Extant methods only produce point estimates for ALE. Given that most health and disability data are from sample surveys, however, valid comparisons of ALE across race must be statistical. Third, in part because of the inability to make statistical comparisons, explanations of racial inequalities in ALE remain completely uninvestigated in contemporary research. I propose to remedy these shortcomings by using a recently developed Bayesian approach to generating multi-state life tables that allows the inclusion of covariates and enables the construction of interval estimates of ALE and other life table quantities. Using this approach, I will first construct interval estimates of gross racial differences in ALE. Second, as part of this process, I will examine age patterns in racial inequality in ALE to determine whether white and nonwhite ALE estimates converge or diverge past midlife. Third, I will begin to explain racial differences in ALE by considering the mediating role of socioeconomic status, and I will expand the investigation to explain age patterns in racial inequality in ALE. This work will serve as a preliminary investigation into more general research examining other measures of health in later life. I intend to apply for an R01 grant in order to examine a more general concept of """"""""healthy life expectancy,"""""""" which, to date, has been largely synonymous with ALE. Few have investigated phenomena other than remaining life spent free from disability, but research should begin investigating remaining life spent more generally in good health, or remaining life spent free from specific chronic diseases or conditions. ? ?
| Lynch, Scott M; Brown, J Scott (2010) Obtaining multistate life table distributions for highly refined subpopulations from cross-sectional data: A Bayesian extension of Sullivan's method. Demography 47:1053-77 |
